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Focus on TB-HIV co-infection: Anbumani

Saturday 25 March 2006

Special Correspondent

50 to 60 per cent of the HIV-positive more vulnerable to tuberculosis; standardised, good quality treatment to be provided to TB patients

National action plan being implemented in a phased manner Community-based surveys among new and re-treatment cases

NEW DELHI: India has achieved 100 per cent coverage under the Revised National TB Control Programme (RNTCP) and it now aims at widening the scope for providing standardised, good quality treatment and diagnostic services to all tuberculosis patients.

"The focus will now be on addressing the TB-HIV co-infection - as 50 to 60 per cent of HIV-positive people are more prone to [contracting] tuberculosis - and tackling multi-drug resistant cases," Union Health and Family Welfare Minister Anbumani Ramadoss told reporters after releasing the RNTCP Status Report for India, 2006, here on Friday to mark World TB Day.

He said a national action plan for TB-HIV coordination was being implemented in a phased manner. In the first phase, the six high-HIV prevalent States of Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Manipur and Nagaland were identified for implementation.

The services are being provided for HIV-infected TB patients under the same roof by establishing critical linkages between Voluntary Counselling and Testing Centres and the RNTCP Designated Microscopy Centres by involving non-governmental organisations.

Monitoring methods

For drug resistance surveillance, the Ministry is conducting community-based surveys among new and re-treatment cases in Gujarat and Maharashtra. Similar programmes will be carried out in other States to help the Government monitor the impact of the programme by observing the trends in resistance.

As of now, drug resistance in new cases is less than 3 per cent and in old cases it is about 10 per cent.

Every year 1.8 million people in India develop tuberculosis and nearly 3,70,000 die from it - more than 1,000 every day. The emergence of HIV-TB co-infection and multi-drug resistant TB has increased the severity and magnitude of the TB epidemic.

Social costs

The disease has devastating social costs as well with data suggesting that each year more than 3 lakh children are forced to leave school because their parents have TB, and more than 1 lakh women with TB are rejected by their families.

With the inclusion of Bihar and Uttar Pradesh under the revised programme, the coverage has touched 100 per cent and the detection rate has crossed 70 per cent. The death rate, too, has come down to 4 per cent from 29 per cent over the years and the treatment success rate has risen from 25 per cent to 86 per cent. Since the inception of RNTCP in 1992, the programme has treated 5.45 million patients, thus saving nearly 9.8 lakh lives.

Pointing out that the country was right on the track as far as dealing with TB was concerned, Mr. Ramadoss said the World Health Organisation Report 2005 also appreciated the Indian programme by saying, "India, with the greatest burden of TB, is also the country where the most dramatic advances are being made in Directly Observed Treatment Short Courses (DOTS) expansion."

See online : The Hindu

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